A patient is one day postoperative following an open thoracotomy. The patient is receiving oxygen mist at 40% by Venturi mask. The patient's ABG results are: pH 7.31, PaO2 93 mm Hg, PaCO2 50 mm Hg, HCO3 25 mEq/L. Which of the following is an appropriate action for the nurse?

Elevate the patient in a high Fowler's position and encourage the use of an incentive spirometer and coughing.

Increase oxygen to 70%.

Switch oxygen to a rebreather mask.

Position the patient prone and have the respiratory therapist perform postural drainage.

Answer and Explanation

The Correct Answer is A

Choice A reason: Elevating the patient in a high Fowler's position can help improve lung expansion and oxygenation, and using an incentive spirometer along with coughing can help prevent atelectasis and pneumonia, which are common postoperative complications.

Choice B reason: Increasing oxygen to 70% without a specific indication could lead to oxygen toxicity, especially without assessing the patient's current oxygenation status.

Choice C reason: Switching to a rebreather mask is not indicated based on the given ABG results and could lead to CO2 retention.

Choice D reason: Positioning the patient prone and performing postural drainage are not typically first-line interventions for a patient one day post-thoracotomy and could be contraindicated due to the recent surgery.

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Correct Answer is B

Explanation

Choice A reason: A pH of 7.39 is near the lower end of the normal range (7.35-7.45) and would not typically indicate respiratory acidosis.

Choice B reason: A pH of 7.31 is below the normal range, indicating an acidic environment, which is consistent with respiratory acidosis.

Choice C reason: A pH of 7.48 is above the normal range, indicating a more alkaline environment, which would suggest respiratory alkalosis, not acidosis.

Choice D reason: A pH of 7.50 is also above the normal range and would indicate alkalosis rather than acidosis.

A. Metabolic alkalosis B. Respiratory acidosis C. Respiratory alkalosis D. Metabolic acidosis

Correct Answer is A

Explanation

Choice A reason: Metabolic alkalosis is indicated by a high pH and a high HCO3 level. In this case, the pH is 7.5, which is above the normal range of 7.35-7.45, and the HCO3 is 32 mEq/L, which is above the normal range of 22-26 mEq/L.

Choice B reason: Respiratory acidosis is characterized by a high CO2 level and a low pH, which is not the case here as the CO2 is normal and the pH is high.

Choice C reason: Respiratory alkalosis typically presents with a low CO2 level and a high pH. Since the CO2 is normal, this condition does not fit the patient's ABG results.

Choice D reason: Metabolic acidosis would present with a low pH and a low HCO3 level. Given that both the pH and HCO3 are high, metabolic acidosis is not the correct diagnosis.

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A patient is one day postoperative following an open thoracotomy. The patient is receiving oxygen mist at 40% by Venturi mask. The patient's ABG results are: pH 7.31, PaO2 93 mm Hg, PaCO2 50 mm Hg, HCO3 25 mEq/L. Which of the following is an appropriate action for the nurse?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who has respiratory acidosis. Which of the following pH levels should the nurse expect?

Correct Answer is B

Explanation

A nurse is reviewing the arterial blood gas (ABG) results of a patient. The patient's ABGs are: pH 7.5 CO2 40 mm Hg HCO3 32 mEq/L Which of the following acid-base conditions should the nurse identify the patient is experiencing?

Correct Answer is A

Explanation

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